Association between cannabis use and suicidal behaviors

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Cannabis is a commonly used psychoactive substance worldwide. It is derived from the Cannabis plant, and its main active ingredient is delta-9-tetrahydrocannabinol (THC).

The use of cannabis has been associated with several physical and mental health issues, including depression, anxiety, and psychotic disorders.

One potential risk of cannabis use is the increased risk of suicidal behaviors, which includes suicidal ideation, suicide attempts, and completed suicide. This report will provide a detailed overview of the association between cannabis use and suicidal behaviors.

Prevalence of cannabis use:

Cannabis is one of the most commonly used psychoactive substances worldwide. According to the World Drug Report 2021, an estimated 200 million people (3.9% of the global population aged 15-64) use cannabis at least once a year, and approximately 40 million people use cannabis daily or almost daily. The prevalence of cannabis use varies by country and region, with higher rates reported in North America, Oceania, and Western Europe.

Association between cannabis use and suicidal behaviors:

Several studies have investigated the association between cannabis use and suicidal behaviors. A systematic review and meta-analysis of 11 studies, including over 23,000 participants, found that cannabis use was associated with a 50% increased risk of suicidal ideation and suicide attempts.

Another systematic review and meta-analysis of 15 studies, including over 306,000 participants, found that cannabis use was associated with a 40% increased risk of suicidal ideation and a 50% increased risk of suicide attempts.

A longitudinal study published in JAMA Psychiatry followed over 1,000 individuals for 35 years and found that those who reported using cannabis in the past year had a significantly higher risk of suicidal ideation and suicide attempts, even after controlling for other factors such as age, gender, and psychiatric disorders.

Mechanisms underlying the association:

The exact mechanisms underlying the association between cannabis use and suicidal behaviors are not yet fully understood. However, several theories have been proposed. One theory suggests that cannabis use may exacerbate underlying mental health conditions such as depression and anxiety, which are known risk factors for suicidal behaviors. Cannabis use has been associated with increased symptoms of depression and anxiety in some individuals, particularly those who use cannabis frequently or in large amounts.

Another theory suggests that cannabis use may impair cognitive functioning, including decision-making and impulse control, which could increase the risk of impulsive suicidal behaviors. Cannabis use has been shown to impair cognitive functioning in some individuals, particularly those who begin using cannabis at a young age or use it heavily.

Treatment implications:

Given the potential risks associated with cannabis use and suicidal behaviors, it is important for healthcare providers to screen for cannabis use in individuals at risk of suicidal behaviors and to provide appropriate treatment when necessary.

Treatment options may include psychotherapy, medication, or a combination of both. Additionally, healthcare providers should educate individuals about the potential risks associated with cannabis use and provide support for reducing or stopping cannabis use when appropriate.

Prevalence of cannabis use among teenagers:

Cannabis is the most commonly used illicit drug among teenagers in the United States, with approximately 6% of 8th graders, 16% of 10th graders, and 22% of 12th graders reporting past-year use, according to the Monitoring the Future study. The prevalence of cannabis use among teenagers varies by region, with higher rates reported in states that have legalized cannabis for medical or recreational purposes.

Association between cannabis use and suicidal behaviors among teenagers:

Several studies have investigated the association between cannabis use and suicidal behaviors among teenagers. A systematic review and meta-analysis of 11 studies, including over 23,000 participants, found that cannabis use was associated with a 50% increased risk of suicidal ideation and suicide attempts among teenagers. Another systematic review and meta-analysis of 15 studies, including over 306,000 participants, found that cannabis use was associated with a 40% increased risk of suicidal ideation and a 50% increased risk of suicide attempts among teenagers.

A longitudinal study published in JAMA Psychiatry followed over 3,800 teenagers for three years and found that those who reported using cannabis in the past year had a significantly higher risk of suicidal ideation and suicide attempts, even after controlling for other factors such as age, gender, and psychiatric disorders.

Mechanisms underlying the association:

The impact of cannabis on mental health in teenagers can be complex, and the exact mechanisms of its effects are not fully understood. However, research has identified several ways in which cannabis use can impact the mental health of teenagers:

  1. Increased risk of depression and anxiety: Cannabis use can lead to changes in brain chemistry that affect mood and motivation. Specifically, cannabis use can increase the release of dopamine in the brain’s reward and pleasure centers, which can lead to feelings of euphoria and relaxation. However, repeated cannabis use can desensitize these receptors, leading to a decrease in dopamine release and potential negative effects on mood. Additionally, cannabis use can lead to increased levels of cortisol, a stress hormone, which can contribute to anxiety and depression.
  2. Increased risk of suicidal thoughts and behaviors: Research has found a strong association between cannabis use and suicidal thoughts and behaviors, particularly in teenagers. This may be due to the way that cannabis affects the brain’s levels of serotonin, a neurotransmitter that plays a role in regulating mood and emotions. Cannabis use can reduce levels of serotonin, which can contribute to depression and suicidal thoughts.
  3. Impaired cognitive function: Cannabis use can have negative effects on cognitive function, including memory, attention, and decision-making. This may be due to the way that cannabis affects the brain’s prefrontal cortex, which is responsible for these cognitive processes. Additionally, cannabis use can lead to changes in brain structure and function, particularly in the hippocampus, which is important for memory consolidation.
  4. Increased risk of addiction: Cannabis use can be addictive, particularly for teenagers. The brain’s reward and pleasure centers are still developing during adolescence, making teenagers more vulnerable to the addictive effects of cannabis. Additionally, repeated cannabis use can lead to tolerance and withdrawal symptoms, which can contribute to the development of a cannabis use disorder.
  5. Increased risk of psychosis: Research has found that cannabis use can increase the risk of developing psychosis, particularly in individuals who are already vulnerable to this condition. This may be due to the way that cannabis affects the brain’s levels of dopamine and serotonin, as well as its effects on brain structure and function. Psychosis is a serious mental health condition characterized by a loss of touch with reality, and it can have long-lasting and severe effects on mental health and overall functioning.

Overall, the impact of cannabis on mental health in teenagers is complex and multifaceted. While some research suggests that cannabis use can have potential therapeutic benefits for certain conditions, such as chronic pain or epilepsy, the risks of cannabis use for mental health must be carefully considered, particularly in teenagers whose brains are still developing. It is important for parents, educators, and healthcare professionals to have open and honest conversations with teenagers about the potential risks and benefits of cannabis use, and to encourage healthy and responsible decision-making when it comes to drug use.

Treatment implications:

Given the potential risks associated with cannabis use and suicidal behaviors among teenagers, it is important for parents, caregivers, and healthcare providers to screen for cannabis use in teenagers at risk of suicidal behaviors and to provide appropriate treatment when necessary. Treatment options may include psychotherapy, medication, or a combination of both. Additionally, parents and caregivers should educate teenagers about the potential risks associated with cannabis use and provide support for reducing or stopping cannabis use when appropriate.

Conclusion:

Overall, there is a significant association between cannabis use and suicidal behaviors among teenagers. The exact mechanisms underlying this association are not yet fully understood, but may involve the exacerbation of underlying mental health conditions and impairment of cognitive functioning. Parents, caregivers, and healthcare providers should screen for cannabis use in teenagers at risk of suicidal behaviors and provide appropriate treatment when necessary. Education and support for reducing or stopping cannabis use may also be beneficial.

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